David S. Meyers, MD; Heather Halvorson, MD, MPH; Sara Luckhaupt, MD, MPH
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Reprints are available from the USPSTF Web site (www.preventiveservices.ahrq.gov) and from the Agency for Healthcare Research and Quality Publications Clearinghouse (800-358-9295 or e-mail at AHRQPubs@ahrq.hhs.gov).
Current Author Addresses: Drs. Meyers, Halvorson, and Luckhaupt: Center for Primary Care, Prevention, and Clinical Partnerships, Agency for Healthcare Research and Quality, 540 Gaither Road, Rockville, MD 20850.
Chlamydial infection is the most common sexually transmitted bacterial infection in the United States, with an estimated 3 million new cases annually. In 2001, the U.S. Preventive Services Task Force (USPSTF) recommended that clinicians screen all sexually active women at increased risk for infection for Chlamydia trachomatis.
To summarize a systematic evidence review commissioned by the USPSTF in preparation for an update of its 2001 recommendation.
English-language articles identified in PubMed between July 2000 and July 2005. Additional articles were identified by bibliographic reviews and discussions with experts. A total of 452 articles were identified.
Explicit inclusion and exclusion criteria were used for each of 3 key questions. For studies of screening in nonpregnant women at increased risk, review was limited to randomized, controlled trials. For other groups, both randomized, controlled studies and nonrandomized, prospective, controlled studies were included.
Using standardized forms, staff of the Agency for Healthcare Research and Quality abstracted data on study design, setting, sample, randomization, blinding, results, and harms.
Only 1 new study met inclusion criteria. This poor-quality study of the effectiveness of screening for chlamydial infection among nonpregnant women at increased risk found that screening was associated with a lower prevalence of chlamydial infection and fewer reported cases of pelvic inflammatory disease at 1-year follow-up.
No new evidence was found on screening in pregnant women, nonpregnant women not at increased risk, or men.
A systematic review found a small amount of new evidence to inform the USPSTF as it updates its recommendations regarding screening for chlamydial infection. There are large gaps in the evidence about screening men to improve health outcomes in women.
Study flow diagram.
*Articles were excluded for the following reasons: did not address screening (n = 10), did not address outcomes of interest (n = 5), or did not meet inclusion criteria for study type (n = 1).
Table 1. Summary of Evidence Reviewed for the U.S. Preventive Services Task Force Update on Screening for Chlamydial Infection
Table 2. Outcomes of Screening 10 000 Asymptomatic Women for Chlamydial Infection*
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Meyers DS, Halvorson H, Luckhaupt S. Screening for Chlamydial Infection: An Evidence Update for the U.S. Preventive Services Task Force. Ann Intern Med. 2007;147:135-142. doi: 10.7326/0003-4819-147-2-200707170-00173
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Published: Ann Intern Med. 2007;147(2):135-142.
Guidelines, Infectious Disease, Sexually Transmitted Infections.
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